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The stretchable, flexible two layered sac the surrounds the heart is called the pericardium. This sac holds just enough of a lubricating fluid between the two layers to allow them to slide over one another with ease. The pericardium sac is what holds the heart in place. It also prevents the heart from over filling with blood and protects it from chest infections. Even so, the pericardium sac is not essential to life since when removed there is no notable difference in the way the heart performs.
There have been rare cases where the pericardium was missing at birth or had weakened spots or holes. In this situation there is danger that a major blood vessel might herniate or bulge through a hole and become trapped causing death within minutes. Due to this these defects are usually repaired or when repairs are not possible the pericardium is completely removed. In most cases, aside from birth defects, pericardial disease has been known to develope from injuries, infections and wide spread tumors. With acute pericarditis there are many causes ranging from viral infections, life threatening cancer, AIDS, heart attack, heart surgery, kidney failure, injury, radiation treatments, systemic lupus erythematosus and leakage of blood from an aortic aneurysm. This disease can also result as a side effect of anticoagulants, procainamide, phenytoin, phenylbutazone and penicillin.
Symptoms of acute pericarditis may include chest pain which extends to the shoulder and down the left arm and fever. The pain with this disease is similar to that of a heart attack with the exception that it is worse when the patient is lying down, coughing or breathing deeply. Acute pericarditis has been known to cause a potentially fatal condition known as cardiac tamponade which is most often a result of tumors, injury, surgery, kidney failure and viral or bacterial infections. This condition is considered a medical emergency and doctors will treat it by surgically draining or puncturing the pericardium with a long needle to remove fluids and relieve the pressure. A local anesthetic is used to prevent the patient from feeling pain as the needle goes through the chest wall. The fluid removal is monitored by using an echocardiography. When the pericarditis is caused by an unknown origin, doctors may drain the fluid surgically, retaining a specimen of the fluid to help with the diagnosis of the cause.
In most cases acute pericarditis can be diagnosed by a doctor by listening to the patient's chest with a stethoscope and the patients description of the pain. The doctor may take a chest x-ray and echocardiography to check the levels of fluid in the pericardium. In some cases the echocardiography may reveal the cause and show how much pressure the pericardial fluid is putting on the right chamber of the heart. Blood test may be taken to detect some conditions such as infections, rheumatic fever, AIDS, leukemia or kidney failure. In most cases the prognosis will depend on the cause. When the cause is not apparent or viral recovery can take up to three weeks. With some diseases such as cancer the patient will rarely survive over 18 months. In all cases the patient will be hospitalized and given drugs to reduce inflammation and pain.
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